MEDICARE: DR. JAN CHANDLER OSBORNE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	39123	KY
2	2084P0800X	Psychiatry Physician	21702	MS

General Provider Information

NPI Number	:	1992789309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAN CHANDLER OSBORNE M.D.

Provider Business Mailing Address
First Line	:	611 ALCORN DRIVE
Second Line	:	CROSSROADS CENTER
City	:	CORINTH
State	:	MS
Zip	:	38834-9321
Country	:	US
Telephone Number	:	662-293-4280
Fax Number	:	662-293-4282

Provider Business Practice Location Address
First Line	:	611 ALCORN DRIVE
Second Line	:	CROSSROADS CENTER
City	:	CORINTH
State	:	MS
Zip	:	38834-9321
Country	:	US
Telephone Number	:	662-293-4280
Fax Number	:	662-293-4282

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	09/30/2011

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Directions to “ DR. JAN CHANDLER OSBORNE M.D.” Practice Location

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